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Retinal Vein Occlusion

What Is a Retinal Vein Occlusion?

Retinal vein occlusion is a blockage in the veins that carry blood away from the retina. Retina specialists are trained to diagnose and treat this condition, which can lead to vision loss if left untreated. Learn more about the symptoms, causes, and treatment options available for retinal vein occlusion.

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What Are the Types of Retinal Vein Occlusion?

Retinal vein occlusions can fall into three categories depending on which blood vessel they affect:

  • Central Retinal Vein Occlusion (CRVO): This condition happens when a blood clot blocks the central vein within or near the optic nerve head. A CRVO can cause blood to hemorrhage in all quadrants of the retina.
  • Branch Retinal Vein Occlusion (BRVO): This blockage occurs in one or more of the smaller branches of the central retinal vein and causes localized bleeding in a single retinal quadrant. BRVO occurs four to six times more often than CRVO.
  • Hemi Retinal Vein Occlusion (HRVO): This occlusion impacts one of the two main branches of the central retinal vein. An HRVO often affects two quadrants of the retina.

Retina surgeons further divide RVO into two categories based on severity:

  • Non-ischemic: Also known as incipient or partial CRVO, this variety makes up 75% of cases. Patients typically experience mild blurry vision that may be most noticeable after sleep and improve throughout the day. (Non-ischemic RVO has a better prognosis than ischemic, but around 34% of cases become ischemic within three years.)
  • Ischemic: This rarer and more severe type of RVO usually leads to dramatic and sudden vision loss, as well as extensive hemorrhaging in the peripheral retina.

Risk Factors for Retinal Vein Occlusion

Even young and otherwise healthy individuals can get an eye retinal vein occlusion. However, the following factors can raise the risk of retinal vein occlusions:

  • Glaucoma
  • Atherosclerosis
  • Diabetes
  • Age-related vascular (blood vessel) disease
  • Hypercoagulability
  • Hypertension
  • Obesity
  • Oral contraceptives
  • Smoking

Retinal Vein Occlusion Symptoms

Symptoms of retinal vein occlusion appear gradually or suddenly depending on the location and severity of the blockage. These signs typically only affect one eye and may include:

  • Hemorrhage: When blood can’t flow freely through the vein, it can spontaneously rupture and leak into the surrounding tissue.
  • Macular edema: The blockage can cause swelling in the tissue in the central portion of your vision. Macular edema can lead to permanent vision damage if left untreated.
  • Blurry vision: Your vision may blur or get spotty over several hours or days.
  • Floaters: You may notice black strands of spots drifting across your vision.
  • Pain: You may feel severe pain and pressure in your eye, which is known as neovascular glaucoma.
  • Redness: Bleeding or tissue swelling can cause visible redness in the eye.

In some cases, RVO doesn’t cause any noticeable symptoms, but regular eye exams can help catch this condition early. If you suspect you have RVO, consult an eye doctor near you immediately.

How Do Retina Specialists Evaluate Retinal Vein Occlusion?

If your primary eye doctor discovers RVO in your eye, you will often be referred to a retinal specialist from M&M Eye Institute. Our retina surgeons are MDs with specialized training in diagnosing, managing, and performing surgery on the retina.

Once you arrive at your our surgery center, your doctor can use several methods to diagnose RVO, including:

1

Dilated eye exam

The specialist will use eye drops to painlessly dilate your eye to provide a better look at your retina. They’ll use office instruments to examine the retina for signs of bleeding and damage. Also, they may test your visual field to determine how much of the peripheral vision has been affected.
2

Optical coherence tomography (OCT)

Your retina specialist may take high-resolution images that reveal a cross-sectional view of the retina. These images detect and measure the buildup of macular edema and can be used to monitor your response to treatment.
3

Fluorescein angiogram

This test allows your doctor to evaluate the blood flow within the retina. The specialist will inject a mild, water-soluble dye into the arm. Next, they’ll take a series of videos or pictures of the retina with a special filter to track the flow of the dye through the blood vessels. This method reveals circulatory or tissue problems.
4

Fundus autofluorescence

This newer assessment detects fluorescent pigments in the retina that may reveal damage or disease. For instance, spots of patchy white can indicate decreased blood flow caused by arterial compression.

These approaches are used to diagnose the type of RVO and assess the severity of the blockage. Additionally, your retina doctor may work with your primary care provider to investigate suspected causes of RVO. For example, they may order blood tests and monitor your blood pressure.

What Treatments Are Available for Retinal Vein Occlusions?

Your retina specialist can recommend various treatments based on the type, location, and severity of your RVO. Here are a few standard RVO procedures:

This innovative new treatment is injected into the eye to treat macular edema caused by BRVO and CRVO. Studies showed that Vabysmo® improves eyesight and reduces fluid in the eye.

Anti-vascular endothelial growth factor therapy: These medications reduce inflammation and fluid leakage in the eye caused by RVO. Your eye doctor may pair anti-VGEF injections with steroids to further reduce swelling.

Your retina specialist can use lasers to seal leaking veins and halt the growth of abnormal blood vessels.

Additionally, your retina specialist will work with your primary care provider to manage any underlying conditions contributing to the RVO. For instance, you may need to take medications like blood pressure medication or insulin to improve your overall well-being.

What else should I know about RVO?

Retinal vein occlusion can happen to anyone and can’t be totally prevented. However, healthy habits like avoiding smoking and exercising can decrease your risk of developing diseases associated with RVO, such as diabetes and hypertension.

Additionally, regular eye exams can help detect RVO early before it causes irreversible vision loss. Some people experience no symptoms of this serious condition, so it’s crucial to get checked regularly.